Multimodal prediction of neoadjuvant treatment outcome by serial FDG PET and MRI in women with locally advanced breast cancer.

Autor: Kazerouni AS; Department of Radiology, University of Washington/Fred Hutchinson Cancer Center, Seattle, WA, USA., Peterson LM; Division of Hematology and Oncology, University of Washington/Fred Hutchinson Cancer Center, 1144 Eastlake (Mail Stop LG-500), Seattle, WA, 98109-1023, USA., Jenkins I; Fred Hutchinson Cancer Consortium, Seattle, WA, USA., Novakova-Jiresova A; Charles University and Thomayer University Hospital, Prague, Czech Republic., Linden HM; Division of Hematology and Oncology, University of Washington/Fred Hutchinson Cancer Center, 1144 Eastlake (Mail Stop LG-500), Seattle, WA, 98109-1023, USA., Gralow JR; American Society of Clinical Oncology, Alexandria, VA, USA., Hockenbery DM; Fred Hutchinson Cancer Consortium, Seattle, WA, USA., Mankoff DA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA., Porter PL; Fred Hutchinson Cancer Consortium, Seattle, WA, USA., Partridge SC; Department of Radiology, University of Washington/Fred Hutchinson Cancer Center, Seattle, WA, USA., Specht JM; Division of Hematology and Oncology, University of Washington/Fred Hutchinson Cancer Center, 1144 Eastlake (Mail Stop LG-500), Seattle, WA, 98109-1023, USA. jspecht@uw.edu.
Jazyk: angličtina
Zdroj: Breast cancer research : BCR [Breast Cancer Res] 2023 Nov 09; Vol. 25 (1), pp. 138. Date of Electronic Publication: 2023 Nov 09.
DOI: 10.1186/s13058-023-01722-4
Abstrakt: Purpose: To investigate combined MRI and 18 F-FDG PET for assessing breast tumor metabolism/perfusion mismatch and predicting pathological response and recurrence-free survival (RFS) in women treated for breast cancer.
Methods: Patients undergoing neoadjuvant chemotherapy (NAC) for locally-advanced breast cancer were imaged at three timepoints (pre, mid, and post-NAC), prior to surgery. Imaging included diffusion-weighted and dynamic contrast-enhanced (DCE-) MRI and quantitative 18 F-FDG PET. Tumor imaging measures included apparent diffusion coefficient, peak percent enhancement (PE), peak signal enhancement ratio (SER), functional tumor volume, and washout volume on MRI and standardized uptake value (SUVmax), glucose delivery (K 1 ) and FDG metabolic rate (MRFDG) on PET, with percentage changes from baseline calculated at mid- and post-NAC. Associations of imaging measures with pathological response (residual cancer burden [RCB] 0/I vs. II/III) and RFS were evaluated.
Results: Thirty-five patients with stage II/III invasive breast cancer were enrolled in the prospective study (median age: 43, range: 31-66 years, RCB 0/I: N = 11/35, 31%). Baseline imaging metrics were not significantly associated with pathologic response or RFS (p > 0.05). Greater mid-treatment decreases in peak PE, along with greater post-treatment decreases in several DCE-MRI and 18 F-FDG PET measures were associated with RCB 0/I after NAC (p < 0.05). Additionally, greater mid- and post-treatment decreases in DCE-MRI (peak SER, washout volume) and 18 F-FDG PET (K 1 ) were predictive of prolonged RFS. Mid-treatment decreases in metabolism/perfusion ratios (MRFDG/peak PE, MRFDG/peak SER) were associated with improved RFS.
Conclusion: Mid-treatment changes in both PET and MRI measures were predictive of RCB status and RFS following NAC. Specifically, our results indicate a complementary relationship between DCE-MRI and 18 F-FDG PET metrics and potential value of metabolism/perfusion mismatch as a marker of patient outcome.
(© 2023. The Author(s).)
Databáze: MEDLINE
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